Actinomycetoma: an Update on Diagnosis and Treatment
Actinomycetoma: An Update on Diagnosis and Treatment Roberto Arenas, MD; Ramón Felipe Fernandez Martinez, MD; Edoardo Torres-Guerrero, MD; Carlos Garcia, MD PRACTICE POINTS • Diagnosis of actinomycetoma is based on clinical manifestations including increased swelling and deformity of affected areas, presence of granulation tissue, scars, abscesses, sinus tracts, and a purulent exudate containing microorganisms. • The feet are the most commonly affected location, followed by the trunk (back and chest), arms, forearms, legs, knees, and thighs. • Specific diagnosis of actinomycetoma requires clinical examination ascopy well as direct examination of culture and biopsy results. • Overall, the cure rate for actinomycetoma ranges from 60% to 90%. not Mycetoma is a chronic infection that develops ycetoma is a subcutaneous disease that can after traumatic inoculation of the skin with eitherDo be caused by aerobic bacteria (actinomy- true fungi or aerobic actinomycetes. The resultant Mcetoma) or fungi (eumycetoma). Diagnosis infections are known as eumycetoma or actinomy- is based on clinical manifestations, including swell- cetoma, respectively. Although actinomycetoma is ing and deformity of affected areas, as well as rare in developed countries, migration of patients the presence of granulation tissue, scars, abscesses, from endemic areas makes knowledge of this con- sinus tracts, and a purulent exudate that contains dition crucial for dermatologists worldwide. We the microorganisms. present a review of the current concepts in the The worldwide proportion of mycetomas is epidemiology, clinical presentation,CUTIS diagnosis, 60% actinomycetomas and 40% eumycetomas.1 The and treatment of actinomycetoma. disease is endemic in tropical, subtropical, and tem- Cutis. 2017;99:E11-E15. perate regions, predominating between latitudes 30°N and 15°S.
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